Akutes Nierenversagen auf der Intensivstation

The RIFLE classification system has drawn attention to the prognostic importance of acute renal failure in patients in intensive care (ICU). The delay of extracorporeal therapy implies an increased mortality and incidence of end-stage renal disease in surviving patients. The start of renal replacement therapy is based on clinical features and a blood urea nitrogen (BUN) level of about 70 mg/dl is only one of numerous markers. Intensity of renal replacement has often been discussed and currently the aim is 25 ml/kg body weight per hour achieved by continuous therapy or 3 to 4 intermittent treatment sessions per week. No improvement was observed when renal replacement therapy was intensified. Currently schedules of best practice care are being developed as the concept of one size fits all is under discussion.